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Home My WebLink About01-1076 ,J, IN THE ORPHAN'S COURT OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of SAMUEL SPUNGIN PETITION FOR GRANT OF LETTERS >>'f)/-/() 7" No. also known as , Deceased Social Security No. 458508167 DEBORAH KLABE Petitioner(s), who is/are 18 years of age or older, apply)ies) tor : (COMPLETE "A" OR "B" BELOW:) o A. Probate and Grant of Letters and aver that Petitioner(s} is/are the execut Decedent, dated and codicil(s} dated named in the Last Will of the State relevant circumstances, e.g., renunciation, death of executor, ete Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: (i] B. Grant of Letters of Administration (c.I.a., d.b.n.c.l.a.: pendente lite, durante absentia; durante minoritate) Petitioner(s} after a proper search haslhave ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence M. Elder Mother 1241 Timberview Drive Mechanicsbur , PA 17050 12 Circle Drive Mechanicsbur , PA 17050 495 Cabin Hollow Rd Dillsburg, PA 17019 Keith John Elder Brother Deborah Klabe Sister (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with hislher last family or principal residence at 661 Mud Level Road, Shippensburg, Southampton Township, PA 17257 (list street, number and municipality) ,~, at 661 Mud Level Road, Shippensburg PA 17257 (location) Decedent, then 51 years of age, died October Decedent at death owned property with estimated values as follows: (if domiciled in PA All personal property ......................................... $ (if not domiciled in PA Personal property in Pennsylvania .................... $ (if not domiciled in PA Personal property in County .............................. $ Value of real estate in Pennsylvania ........................................................................................ $ Total ..................................................................................................................... $ Real Estate situated as follows: N/A Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: 100.00 0.00 100.00 Typed or printed name and residence DEBORAH KLABE 495 Cabin Hollow Road, Dillsbur , PA 17019 Oath of Personal Representative Commonwealth of Pennsylvania County of CUMBERLAND The Petitioner( s} above-named swear( s} and affirm( s} t and correct to the best of the knowledge and belief of Petitioner(s} Decedent, Petitioner(s} will well and truly administer the estate Sworn to and affirmed and subscribed before me this 26th day of N~OOe. ~~~ Mary C/' Lewis ~ ('''''''\ ~" -'I ;- (, - . "tiC >;::.. -0 N :...:. N 'ur~. DECREE OF REGISTER OF WILLS Estate of SAMUEL SPUNGIN Deceased No. 21-2001-1076 also known as Social Security No: 458508167 Date of Death: 10/15/01 AND NOW, November 27th I 2001 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters 0 Testamentary I!I of Administration ((c.ta., d.b.n.c.t; pendente lite; durante absentia; durante minoriate) are hereby granted to DEBORAH KLABE in the above estate and that the instrument(s}, if any, dated described in the Petition be admitted to probate and filed of record as the Last Will of Decedent. FEES Letters .................................... $ 18.00 Short Certificates( s} ... ..(..~. ~..... Renunciation ... ..<'2. L............. Extra Pages ( ) ............... I.T.R....................................... JCP Fee ................................. Inventory .. ........... ................... Other..................................... . $ 12.00 $ $ $ $ $ $ $ 10.00 Signature 5.00 Attorney: Maxine Kay Lewis, Esquire I.D. No: 33085 Address: 1101 North Front Street Harrisburg Telephone: 717 234-3136 DATE FILED: NOVEMBER 27TH, 2001 PA 17102 TOTAL .............................$ 45.00 MAILED LETTERS TO ADMINISTRATORS ~ ~ CONTINUATION OF PETITION FOR GRANT OF LETTERS ESTATE OF SAMUEL SPUNGIN, DECEASED 21-2001-1076 Decedent's Father. predeceased DJcedent. De.c c"ee e9t t"ss ~ MotJler and Brother .lrJ:tt, d/.J:ia7IJ /?'lIVer!, It/I )"?~ ~ /{tdk- have executed Renunciation Forms in favor of Deborah K1abe. The death certificate and Renunciation Forms are being filed with the Petition for Grant of Letters. '1~:i;"':~b5 'p' ~TZi 00) O(J,) <Da: ex: p oo:;t t-:.{ .:, 0.. ~:) ) " N 0... \0 N :::> 5! 'J.) l.:.!:l ....s:: .:u= 50 1..11 (\".~"" 'l;),"'=.V 0/,0{;. This is to certify that the information here given is correctly copied fro~ an original certificate of death dul~ fileclwith Local Registrar. The original certificate will be forwarded to the State VItal Records Office for permanent filtn@;. WARNING: It is illegal to duplicate this copy by photostat or photograph. me as No. Fee for this certificate, $2.00 p 7782524 ad /tf; ,;ftJOI , Date 21-2001-1076 tv 2/17 COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH AOElla. ~ UNDER' - .,.,. I"" lCotyaftd '3t.IlAorFCf~Counlrvt 1T#G"'IlI~" SOC'Al.SECU"'TYNUM.'. -'-~~'M-;;;';;'O;;:;;;;;,--.", .. 458 50 - 8167..--1'. IO-15=2.llil-L-___. HIC~Of'Ily."...--...""'ruct.oflton_~.. ___~_____ H~iNfii;.,~~.--..--'-.-~-. .. v... ="YIO COUNrt C# H Cumberland DECEOENt'S USUAL (~-=:_:O~~~ Accountant MARITAl. ITRUS......... SURVMNQ SPOUSf: Ne..... u.....1ed, WIdowM. I".... ~ maodIIrl NIlmeI -- Never Harried ~ ....a:....._...... Southampton - 661 Hud Level Road '0. Shippensburg, PA 17257 f'AIltER'S HAME (FirIl. MIddle. Lalit) II. Emanuel S ungin _.-......s_(I I Dorothy M. Elder METHOD c# DtSPOSITION _CD ",-...0 ___0 _0""",_ . 11.. ,"- Cumberland ,,,,.0 :::..."'::'.':::'.. MOTHER'S NAME IF.,_. Mo:II. ,...., Surt\llN) Dorothy H. Anderson OAMAHT'S MAIlING ADDRESS (StreM. CIfy(bwn. .... Zip Codel 1241 Kimber View Dr., Mechanicsburg. PA 17050 Cll'1lI ._..~"- LOCRlClN."""-'._.lloeo. .."""'''*' Dauphin County 110. Mt . I.. Lowe r Paxton Tw ~ 19 2001 NSE NUMBER 011776-L PA PA \7257 .S CAS( REfl ARED m MEDICAl EXAMINE ....0 ... [l'V"'" _ICAUMlF"* -..- '-*'o"'CflMIh)-' .~~~ I: .- '-- :onMIMd~ I I i MIlT I: Ottw I9tifleanl CiOnlMoNcnntrlbuttn9to dHIh. buI noI....""'lIntfte~c-.. """ IrI AVn' I -..- It~......... ......... ~, Ene. ........"... . CAUSllIlIMMe OI~., --- r-..no"'~'lAIT A. ACONSE NeE Of}' DUE 10 COR AS A CONSEOUEHCt OF}: MS AN AU10PSY WERE AUlOPSY fllNDtNGS MANNER OF DEATH PERFORMED? -.-.E PAlOll '" )g( COUPlE'11ON OF CAUSE 0 Of' OEAI'H? ........ - - 0 --,..,... 0 ....0 ,J( ....0 ...~ ....... 0 Could nDI be .-..rm1Md 0 ORE OF lHJUAy lManIh, DIy, ...., flME OF INJURY ItUJRV 1fJ 'MJAK? DESCAI8E HOW INJUAY OCCUAAED ... 0 ...0 "DIeM. DAIltNf.RJCORONE.. On the ..... of ...mlnatlon andlrwlnvestl.a11oft. In my opnlOn, de.... occurred at ttM tlrn.. dale, and plHa, Md due to .... ceuMC.)..... IIIMMr.....Ied......... .... ........ ...... ...... ...... ........ ..................... ..... ........... .......... .... )ta. REGISfRAFrs SIGNATURE AND HUMBER 12, t; t-~ ~ - - CUlT... ~ ontyOl'llt) oca"T""'~A"(Ph~cM1lfylnQ eaMoldnlh ~~ DhvIcoentl..cwonoune.t deMhanocomplel<<tlfllm :l'3l T..........""~, ....rttoccurred........caua-<.J.ndllNftM,........................................ ... OPRONOUNClNQ AHa C8n'1"lNG ,..,.11C1AN ~ rlOItI P'0f'l0UAC1tlQ dHItl ~ certrIyInq 10 c.... of dH1tIl TIIIfMI....... "" ~.. de.", occurred 8t......... dalte. and ptIIee........ Ie the c."l...nd mann.,.. ItIIled u ... -Iw -&xJI - &' ((Jr.! /?; ,~f1!) ( / IN THE ORPHAN'S COURT OF FRANKLIN COUNTY, PENNSYLVANIA RENUNCIATION Estate of SAMUEL SPUNGIN No. 21-2001-1076 also known as , Deceased The undersigned DOROTHY MIRIAM ELDER I (Relationship) MOTHER (Capacity) of the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters of Administration be issued to DEBORAH KLABE Witness my hand this day of October , 2001 . ~ p{.L,uLlA/ 1241 TimbervisW51ive Mechanicsburg PA 17050 (Address) - ~ - . . CJ.. N - (Signature) 0- ci l"C) N ',,) (Address) (' ;~"\ ::> i'i::i G I],.: S! t, i:;;, 03 .....,.. e;.) ,.!) 0 ts:: (Signature) (.") (I) - a> a:: p \1)= ........ .-II a: ~O (Address) Sworn to or affirmed and subscribed before me this c:< c.jth day of ~La~~ Notary Public M " NOTARIAL SEAL AN~IA Q, I\NOERSON, Notary Public \ I Fr?>nkiir TWD. Yor~ County .!r/~'.'Iv e.omm.1 ISS.S .110 ,I" Expire; Dec. 3, 2001 . (SltJ..!U!r!' lI..1lSUealotNfililry or...otber--.--- official qualified to administer oaths. Show date of expiration of Notary's commission.) NOTE: Renunciations executed outside the Office of Register of Wills are required in some counties to be notarized. RW-3 IN THE ORPHAN'S COURT OF FRANKLIN COUNTY, PENNSYLVANIA RENUNCIATION Estate of SAMUEL SPUNGIN No. 21-2001-1076 also known as , Deceased The undersigned, KEITH JOHN ELDER HALF-BROTHER (Relationship) (Capacity) of the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters of Administration be issued to DEBORAH KLABE Witness my hand this day of October , 2001 . ,~p ~-~ 12 Circle Driv Mechanicsburg PA 17050 (Address) - OVJ ~;;~ - - . . -.,..,. ~jct ':..> (Signature) N a... " d"_~1 {I) Cf 1:::; c)";:h ~Q) a:: a: 1.0 N ::> 5! (Address) 'C; '\~I .' p ,3.; ~.o ....s:: 11>= uc:5 (Signature) (Address) Sworn to or affirmed and subscribed before me this ,;? L/ tl; day of ~ 02001. - 4ch~- Notary Public lMY-CO~qn,~xp~~~L iN~i I~ 'i, Af\;OERSOI\ NoI3.ry Puolic : Fr8i1kiin Twp. York County I My Commission Expires Dec. 3. 2001 , .lnU seal or Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission.) NOTE: Renunciations executed outside the Office of Register of Wills are required in some counties to be notarized. RW-3 Law Offices MAXINE KAY LEWIS 1101 North Front Street Harrisburg, Pennsylvania 17102 Telephone (717) 234-3136 Fax (717) 234-8288 OF COUNSEL Robert W. Greenfield 1982-1997 July 2, 2002 Inheritance Tax Division Commonwealth of Pennsylvania Department 280601 Harrisburg, P A 17128-0601 Register of Wills for Cumberland County Hanover & High Streets Carlisle, P A 17013 Re: Estate of Samuel Spungin, Deceased File No. 2001-01076 Date of Death: October 15,2001 Dear Sir/Madam: Please be advised that I am the attorney for the Estate of Samuel Spungin, Deceased. This letter is to request an extension of time in which to file an Inheritance Tax Return for the above estate. The estate is waiting for a document which will be an exhibit with the Inheritance Tax return. A payment for estimated inheritance taxes will be made on or before July 15,2002. Thank you for your kind consideration of this request. Since'L~~~ ~~ MAXINE KA Y LEWIS MKL/I p.c.: Deborah Klabe, Administratrix f"......;- r Q) Ul ::::1 o ..c: Ul +J +J l-l Q) ::::1 Q) Q) o l-ll-lM U cO +J ...-l ::::1U)0 :>t u) 0" l' +J...::tu)..c:...-l ~ ...::t bl ::::1 H Q).r-! O:3:Ul::r:l U ::::1 ~ ~O'OPl 't:lO..c:~ ~ +J cO .. cOp::jl-l Q) ,-Hil ::::1 l-l r-l l-l80Q)Ul Q) U) U :>.r-! .0 H O....-l St!)Q)~l-l ::::1~~COCO Up::jO::r:lU ,;-.1 I~) ...:' ...:' 'l'f: ...:a 'J..f .:::. I'" ...., " N 0 ~ l' IU - C -,nr IU 0( ,- e Ir ~ Z III 0( ~ > Z ...J > 0 III Ir Z 10. Z :r IU ~ Q. Ir 0 0 Z Ir ::> 0 CD - III - Ir Ir <( J: /1-do-5 t-/ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPARTMENT 280601 HARRISBURG, PA 17128-0601 July 10, 2002 Telephone (717) 787-3930 FAX (717) 772-0412 Maxine Kay Lewis. Esq. 1101 North Front St. Harrisburg, Pa.17102 Re: Estate of Samuel Spungin File Number 2101-1076 Dear Mr Lewis: This is in response to your request for an extension of time to file the Inheritance Tax Return for the above estate. In accordance with Section 2136 (d) of the Inheritance and Estate Tax Act of 1995, the time for filing the return is extended for an additional period of six months. This extension will avoid the imposition of a penalty for failure to make a timely return. However, it does not prevent interest from accruing on any tax remaining unpaid after the delinquent date. The return must be filed with the Register of Wills on or before January 15,2003. Because Section 2136 (d) of the 1995 Act allows for only one extra period of six (6) months, no additional extension(s) will be granted that would exceed the maximum time permitted. ", ,,? f/;' Sin<fjfeIYri.i1 ,) (; 1"'1 .'/'.' ../ if ". / '/ ',' '" ':/. 'I' Ii '/~ v;' 1" ,,' // "( , .." / / / " "'~ 7/:.Jil-'b(;-L-(Z;/~)-V:~""'/ -' JeffreyD. Hollenbush, Supervisor Document Processing Unit Inheritance Tax Division COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE BUREAU OF INOIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT LEWIS MAXINE KAY ESQUIRE 1101 NORTH FRONT STREET HARRISBURG, PA 17102 ------~- fold DUPLICA TE ESTATE INFORMATION: SSN: 458-50-8167 FILE NUMBER: 2101-1076 DECEDENT NAME: SPUNGIN SAMUEL DATE OF PAYMENT: 07/16/2002 POSTMARK DATE: 07/1 5/2002 COUNTY: CUMBERLAND DATE OF DEATH: 10/15/2001 ACN ASSESSMENT CONTROL NUMBER 101 TOTAL AMOUNT PAID: REMARKS: DEBORAH KLABE C/O MAXINE KAY LEWIS ESQUIRE CHECK#107 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS REV-1162 EX(11-96) NO. CD 001412 MARY C. LEWIS REGISTER OF WILLS AMOUNT $967.50 $967.50 INVENTORY Estate of SAMUEL SPUNGIN ____, Deceased No. 21 01 1076 Date of Death 10/15/01 Social Security No. 458-90-8167 also known as__ khcJ~/lH klZ -#Be::- Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Personal Representative: Name of Attorney: Maxine Kay Lewis 1.0. No.: 33085 Address: 1101 N . Front St. Harrisburg, Telephone: (717) 234-3136 Deborah Klabe Dated i;/ 2-/03 PA 17102 Description Distribution from Estate of Fannie Spungin, Deceased Value 97,225.48 Total (Attach Additional Sheets if necessary) 97,225.48 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, indude the value of each item, but such figures should not be extended into the total of the Inventory. RW-4 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT, 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT LEWIS MAXINE KAY ESQUIRE 1101 NORTH FRONT STREET HARRISBURG, PA 17102 __nUh fold ESTATE INFORMATION: SSN: 458-50-8167 FILE NUMBER: 2101-1076 DECEDENT NAME: SPUNGIN SAMUEL DATE OF PAYMENT: 01/15/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 10/15/2001 NO. CD 002049 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $2,571.31 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: DEBORAH KLABE C/O MAXINE KAY LEWIS ESQUIRE CHECK# 141 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS $2,571.31 DONNA M. OTTO DEPUTY REGISTER OF WILLS COMMONWEALTH OF PENNSYl VANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT KLABE DEBORAH 495 CABIN HOLLOW ROAD DILLSBURG, PA 17019 ___uh_ fold ESTATE INFORMATION: SSN: 458-50-8167 FILE NUMBER: 2101-1076 DECEDENT NAME: SPUNGIN SAMUEL DATE OF PAYMENT: 05/13/2003 POSTMARK DATE: 05/12/2003 COUNTY: CUMBERLAND DATE OF DEATH: 10/15/2001 NO. CD 002561 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $ 5 5.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: DEBORAH KLABE CHECK#145 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS $ 55.00 DONNA M. OTTO DEPUTY REGISTER OF WILLS )'1,:) c: ",--oF /--' \., BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT * REY-1U7 EX AFP [01-03) Reeo,:,;;;:: OT DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 05-27-2003 SPUNGIN 10-15-2001 21 01-1076 CUMBERLAND 101 SAMUEL MAXINE KAY LEWIS 1101 N FRONT ST HBG .03 JUN -6 All :48 Allount RelliUed uai7102 Cumbe, MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=i6o-j-Ex--AFP--foY:03Y------...--iNirERITANCi--YAX--sriffEMi-NY-ifF'-ACCoUiff--...--------------------- ESTATE OF SPUNGIN SAMUEL FILE NO.21 01-1076 ACN 101 DATE 05-27-2003 THIS STATE"ENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NA"ED ESTATE. SHOWN BELOW IS A SU""ARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAY"ENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 03-03-2003 P R I N C I PAL TAX DUE: uuu""u'u'u'u'Uu"'u"',"uu........u"',"'uu.."'..,...,..'u"''''u"""""""''''uuu'''.."........'''''''''uu....,.........uuuuuuu"""..,..,'''''''''u'''u"......"''''''''''uu 3,515.01 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 07-15-2002 CDOO1412 .00 967.50 01-15-2003 CD002049 23.80- 2,571.31 05-12-2003 CD002561 52.04- 55.00 TOTAL TAX CREDIT 3,517.97 BALANCE OF TAX DUE 2.96CR INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 2.96CR . SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAY"ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. ) .-/ 1~-~.g-6 ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER i COUNTY ACN II MAXINE KAY LEWIS 1101 N FRONT ST HBG PA 17102 03-03-2003 SPUNGIN 10-15-2001 21 01-1076 CUMBERLAND 101 Allount Rellitted *' REY-1547 EX AFP lDl-UI SAMUEl MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=is4j-EX--AFP-foY=03Y-NOT-icE--OF-YNHER-iTANCE-TAX-jrpPRjrisEi"-ENT~--ALi-oWAifcE-OR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SPUNGIN SAMUEl FILE NO. 21 01-1076 ACN 101 DATE 03-03-2003 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax TAX RETURN WAS: (X) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets NOTE: I~ an assessment was issued previously, lines re~lect ~igures that include the total o~ ALL ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: DATE 07-15 2002 01-15-2003 n___.. . NUMBER CD001412 CD002049 \+} INTEREST/PEN PAID (-) .00 23.80- ( ) CHANGED (1) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 97.225.48 .00 .00 (8) (9) (10) 18.989.21 125.00 (11) (12) (13) (14) NOTE: To insure proper credit to your account. subllit the upper portion of this forll with your tax paYllent. 97.225.48 19.114 21 78.111.27 .00 78.111.27 14, 15 and/or 1&, 17, 18 and 19 will returns assessed to date. .OOXOO= 78.111.27 X 045 = .00 X 12 = .00 X 15 = (19)= AMOUNT PAID 967.50 2.571.31 BALANCE OF UNPAID INTEREST/PENALTY AS OF 01-16-2003 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE · IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .00 3.515.01 .00 .00 3.515.01 3.515.01 .00 52.04 52.04 ( IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU MAY BE DUE A REFUND. 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In 0 l:Q .... ~I OZr-l :Er-l C I ;:)6r-l;:)0 ~ ~lL NUr-l II Oll)r-l C ::I: ~III:: :Jill ILgl OIL:;) IIIOZ~ ~ IIIZ 1II~~..I:;)5 ~(I)CHOC ~lIIglLU '''..,~ ":~ q,.; ~,,_. C;i l'-, J) J:I: ':'! o :E:( M - >- ~ p ~I- 311) UJI- .....z >0 CCO:: :ill::LL UJZ Z 1-1 r-l ,.. Xo.... Cr-ll:Q :Er-l::E: if :::6 N'>:: Cl,' m r-l:.o 1',:-':: ~ "1J)5 cOo lL (I) g III:: o U III III:: III:: :;) o > III:: o IL Z o H ~ III:: o a. III:: III 3 o ..I Z H C ~ III III:: I I I 'I. I I . I I I I III: ZI HI ..I: I (1)1 HI ::1:' ~: I C!>>I Z' 0: ..I, CI I ~' :;): UI I ~ ~ ~ ~ ~~ ~~ ~~ ~ '1 ~' , ~ ~'9 ''0~ - ~~,~1 ~'j! Vd ,~ '(!jl~~ 'i ~;:: l'!nO~ ~,' ""'-J C) ~ i~ (0. .r" l t': ot\:l (l ^~h - - ~ ~ " F ,:"s!f3atl .' :+;) 'lo~eH ' .-,r:J~_~...... ~J Law Offices MAXINE KAY LEWIS 1101 North Front Street Harrisburg, Pennsylvania 17102 Telephone (717) 234-3136 Fax (717) 234-8288 or (717) 652-2318 E-mail: MKLoffice@comcast.net OF COUNSEL Robert W. Greenfield 1982-1997 September 18, 2003 Cumberland County - Register of Wills Hanover and High Streets Carlisle, P A 17013 RE: Estate of SAMUEL SPONGIN File No. 21 01 1076 Dear Sir/Madam: Enclosed please find the original and two copies of Supplemental Inheritance Tax Return (INH), Inventory (INV) in the above-referenced estate. Also enclosed are two checks, one in the amount of $225.00 for additional probate costs and filing fees for the INH and INV, and another in the amount of $4,462.96 for the Supplemental Inheritance Tax. Finally, I have enclosed a self-addressed envelope for return of one file-clocked copies of the INH and INV. Thank you for your assistance. Ifthere are any questions concerning this filing, please contact me at (717) 652-2296. Sincerely. ~. MAXINE KAY LEWIS MKL/cmm enclosures ~~K Name of Decedent: STATUS REPORT UNDER RULE 6.12 :5'f} fI1LJ fC"L S'pLl tV G-r N Date of Death: /0 / /5 /2-D(') i Will No.: Admin. No.: ;l66 I - 61 (}) 7 6 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes 0 No ~ 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: /J-e c e P1-t ~ 02 0<0...3 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No 0 b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes 0 No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: ~)I03 tUA~ <A.U2- kAt ~~ Signature p'h Ii 'XI N'~ k ~ C-eWL.s Name ,;-- 1;01 .110~ ~ ,J'~ Address f/-c:::u-:'~~~?c ;;4 /, /0.2- (71 7) 2-3'1_ J / 3' ~ Telephone No. Capacity: 0 Personal Representative ~nsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 003042 LEWIS MAXINE KAY ESQUIRE 1101 NORTH FRONT STREET HARRISBURG, PA 17102 ACN ASSESSMENT CONTROL NUMBER AMOUNT -------- fold 101 $4,462.96 ESTATE INFORMATION: SSN: 458-50-8167 FILE NUMBER: 2101-1076 DECEDENT NAME: SPUNGIN SAMUEL DATE OF PAYMENT: 09/22/2003 POSTMARK DATE: 09/18/2003 COUNTY: CUMBERLAND DATE OF DEATH: 10/15/2001 TOTAL AMOUNT PAID: $4,462.96 REMARKS: DEBORAH KLABE - C/O MAXINE KAY LEWIS CHECK# 181 SEAL INITIALS: DO RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS t , , . . . i . . ~f ~.. ......'~"~"r8.-.~. . THTj"'" .....: L_ i .JI f.J2-,':v.....:. '--'i'-...,~;.Jd." . .# .fl 4 k ..11it111'!J. .,..... ,J!' /' ji LEWIS LAW OFFICES 1101 North Front Street Harrisburg, Pennsylvania, 17102 ,!;:;it- 1~~ ;JA /ltJ'3 ., . .'. ..~............ ..... .i -:',,"-'-,.;',::;,:-.<- ':i .. ~ _ '. :'4"/<_ .::;"'!>_.-.,.... ""..-......."......,~.,:;"....,-:.'.- .~.'; /~ I!f. '"' ...fiI:X. ~~' . , ~ t., .. \. ~ .-.\~.. f' """-4 ~ .-. to ;r J. ...."...:"..... ~, .x ",'6t;". > .~.. ... '. l. i'., . f'<,~ ;~ /f f1t1 E"N.b ED INVENTORY ~ ~ Estate of SAMUEL SPUNGIN , Deceased No. 21 01 1076 Date of Death 10/15/2001 Social Security No. 458-90-8167 also known as DEBORAH KLABE Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: MAXINE KAY LEWIS 1.0. No.: 33085 Address: 1101 N. Front St. Harrisburg Telephone: 717234-3136 Dated 9/18/2003 PA 17102 Description Distribution from the Estate of Lena Spungin Value 97,225.48 Further Distributions from the Estate of Lena Spungin 97,177.00 Total (Attach Additional Sheets if necessary) 194,402.48 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. RW-4 Pm;lage $ r-'l o 00 Return 1m lept =ee (Endorsernen' R equirE,d) C 'rt fiee =ee Postmark Here o Restricted D,li"ery '="13 r-'l (Endorse men R 3qu II Ed) o r-'l Total Posta Ie & Fues $ '---~\c..~ Stniiii,Apfiit:;; on_ - - n___ ----- .._..__ _n_______________________________________________ or PO BoxNc. citY: -SiBie;zi ,;; '4-- - ------ .----..--------------------------------------------------.--- rn o Sent To o I"'- See Reverse for Instructions SENDER: COMPLETE THIS SECTION . Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. X . Print your name and address on the reverse so that we can return the card to you. . Attach this card to the back of the mail piece, or on the front if space permits. COMPLETE THIS SECTION ON DELlVERv o Agent o Addressee Cj pa.te of Delivery I-IInI-1 address different from Item 1? 0 Yes tar delivery address below: 0 No 1. Article Add....~~o.. ... KAY ESQUIRE LEWIS MAXIN~RONT STREET 1101 NORTH 17102 HARRISBURG PA / 3. S~ice Type 121 CertIfIed Mall 0 Express Mall o Registered 0 Return Receipt for Merchandise o Insured.Mall 0 C.O.D. 4. Rest~cted Delivery? (Extra Fee) 0 Yes 2. Article Number (Transfer from service label) PS Form 3811, February 2004 7003 1010 0001 1204 1373 Domestic Return Receipt 102595-02-M-1540 -, · ~Omp/?te ite":,s 1, 2, and 3. Also complete ite:m 4 If Restricted Delivery is desired. · Pnnt your name and address on the reverse so that we can return the card to you · Attach this card to the back of the m~i/piece or on the front if space permits. ' 1. Article Addressed to: o Agent Addressee C. Date of Delivery Ur')..~y D. Is delivery address different from Item 1? 0 Yes r delivery address below: 0 No KLABE DEBORAH 495 CABIN HOLLOW ROAD DILLSBURG PA 17019 2. Article Number (Transfer from servIce 18be/) =- ! PS Form 3811, February 2004 ri' Certlfi;,d ~all 0 Express Mall o Registered 0 Return Receipt for Merchandise o InSured Mall 0 C.O.D. 4. Restricted Delivery? (Extra Fee) 0 Yes 7003 1010 0001 1204 1366 Domestic Return Receipt l02595-02-M.l540 .. . JRD/June 30.. 1992/17858 ~ . . :..H)V 0 ~ 2004 Estate No.: 21-01-1076 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA In Re: Estate of Samuel Spungin Late of Southampton Township NO. 21-01-1076 NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: Deborah Klabe Counsel for Personal Representative: Maxine Kay Lewis Date of Decedent' s Death: 10/15/2001 Date of Delinquency Notice: 08/11/04 The undersigned, Glenda Famer-Strasbaugh, Clerk of Orphans' Court, in accordance with Rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Clerk ofthe Orphans' Court on April 30, 2004, and that the ten (10) day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 11/08/04 .bJ ~ ~ ~ ~ilaF'aA{er sr:.:s{,';-ugi,---7:T- - Clerk of the Orphans' Court Distribution: Personal Representative Counsel for Personal Representative Estate File ~~'(..IC;;\ ucq. q'.~<J fltI.lV\. A hearing is scheduled for at in Courtroom No.3. If the Status Report is filed the hearing date, the hearing will automatically be cancelled. ./ "' y. ,....' /' .,,' ,',:) ,i' ,":' r. " .' ~ _,- ,::_, .:' ji. George :p,{Hof~er, 'Ii.J /.' vJ V 7-c2.:3 -O~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* REY-liD? EX iFP 101-051 MAXINE KAY LEWIS 1101 N FRONT ST HBG DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 10-27-2003 SPUNGIN 10-15-2001 21 01-1076 CUMBERLAND 101 SAMUEL Allount Rellitted PA 17102 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REY=i6cfi-i3f-AFP--foY=oiY------...--iNHERIi'ANCE-YAX-STAfEM'fNY-OF'-AC-couiif--...---------------- ----- ESTATE OF SPUNGIN SAMUEL FILE NO. 21 01-1076 ACN 101 DATE 10-27-2003 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 03-03-2003 P R I NC I PAL TAX DU E : ........................................................................................................................................................................................................................... 3,515.01 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 07-15-2002 CDOO1412 .00 967.50 01-15-2003 CD002049 23.80- 2,571.31 05-12-2003 CD002561 52.04- 52.04 TOTAL TAX CREDIT 3,515.01 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATE. SEE REVERSE TOTAL DUE .00 . SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRl. YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) \, / ')-c2.3 -~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REY-1547 EX AFP lDl-05l j /; FILE NUMBER 21 01-1076 ..'. 'COUNTY CUMBERLAND MAXINE KAY LEWIS ACN 501 1101 N FRONT ST I Anount Renitted I HBG PA 1710:e> MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ iffv:i54j-E;f-AFP--foY:03Y-NoYicE--oF-YNHEifiTAiicE-'~fAx-jrpPRAisEMENT~--AL1-owAircE-oR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SPUNGIN SAMUEL FILE NO. 21 01-1076 ACN 501 DATE 11-10-2003 TAX RETURN WAS: ( X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: LITIGATION RETURN 1. Real Estate (Schedule A) U) .00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) .00 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 subnit the upper portion 4. Mortgages/Notes Receivable (Schedule D) (4) .00 of this forn with your S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 99,177.00 tax paynent. 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7) .00 8. Total Assets (8) 99,177.00 APPROVED DEDUCTIONS AND EXEMPTIONS: .00 9. Funeral Expenses/Adn. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) llO) .00 11. Total Deductions (11) 00 12. Net Value of Tax Return (2) 99,177.00 13. Charitable/Governnental Bequests; Non-elected 9113 Trusts (Schedule J) (3) .00 14. Net Value of Estate Subject to Tax ll4) 99,177.00 NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Anount of Line 14 at Spousal rate US) .00 X 00 = .00 16. Anount of Line 14 taxable at Lineal/Class A rate (6) 99,177.00 X 045 = 4,462.96 17. Anount of Line 14 at Sibling rate ll7) .00 X 12 = .00 18. Anount of Line 14 taxable at Collateral/Class B rate (8) .00 X 15 = .00 19. Principal Tax Due ll9)= 4,462.96 TAX CR ITS: I"AYI IT I+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 05-12-2003 CD002561 .00 2.96 09-18-2003 CD003042 .00 4,462.96 TOTAL TAX CREDIT 4,465.92 BALANCE OF TAX DUE 2.96CR INTEREST AND PEN. .00 TOTAL DUE 2.96CR III IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ...lIIIII DATE 11-10-2003 ESTATE OF SPUNGIN DATE OF DEATH 10-15-2001 SAMUEL 1?-~.3~ ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* REY-16D7 EX AFP lDl-OSl MAXINE KAY LEWIS 1101 N FRONT ST HBG DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 11-10-2003 SPUNGIN 10-15-2001 21 01-1076 CUMBERLAND 501 SAMUEL Allount Rellitted PA 17102 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 NOTE: To insure proper credit to your account. subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=i6'ifi-Ex-AFP-[oY:oiY------...-iNHERITANc'E-YAX-STATEMEN'Y-'ifF-ACrCoi:iiiT--...---------------- -- --- ESTATE OF SPUNGIN SAMUEL FILE NO.21 01-1076 ACN 501 DATE 11-10-2003 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE. APPLICATION OF ALL PAYMENTS. THE CURRENT BALANCE. AND. IF APPLICABLE. A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-10-2003 PR I NC I PAL T AX DUE: ........................................................................................................................................................................................................................... 4.462.96 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 05-12-2003 CD002561 .00 2.96 09-18-2003 CD003042 .00 4.462.96 TOTAL TAX CREDIT 4.465.92 BALANCE OF TAX DUE 2.96CR INTEREST AND PEN. .00 lIE IF PAID AFTER THIS DATE. SEE REVERSE TOTAL DUE 2.96CR SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ. YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J STATUS REPORT UNDER RULE 6.12 Name of Decedent: Samuel 5/Ju19;'/J / I Date of Death: / /) 15/01 f ' Will No.: 1/-())-/()76 Admin. No.: 2f-tJ/-/tJlt Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes ~ No 0 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. !fthe answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes _ No ~ b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes rtI No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk ofthe Orphans' Court and may be attached to this r~epr .Jt #it ~. Date: IJ/11!O~ ~t~ Si ature J/IJlfelJtllll Ii bll/iSj ESf. Name '.II r-- //0/ AIr fimfJI. ,Jlr,/If/?/t12 Address / (711) Z3~-3/5* Telephone No. ' '.' p Capacity: n Personal Reoresentative ~ Counsel for "personal representative. rJf~':1rt/ CP(/t7fe/ ,'5 cleallfU(. .I tbn -j).(. exetvlor ~'f!lf/E51:,.k atd kfle OJ1t/tt1ed1he ab()(/e /(//IJ fie It/mol ;2e;JffftrrIJ/ve ) REV-1500 EX + {6-00} . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT I- Z W C w (J w c DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SPUNGIN, SAMUEL DATE OF DEATH (MM-DQ.Year) DATE OF BIRTH (MM-DD-Year) 10/15/2001 09/06/1950 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST. AND MIDDLE INITIALI W I- ~:!cn 0"'''' LU~O :t:o::9 08:1I1 '" [RJ 1. Original Return o 4. Limited Estate o 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copy of Trust) o 10. Spousal Poverty Credit (date of death belween 12-31-91 and 1-1-95) I- Z W o z o .. Ul W '" '" o o NAME MAXINE KAY LEWIS FIRM NAME (If Applicable) OFFICIAL USE ONLY c / '7 - ~ 3 - s- FILE NUMBER 2 1 - 0 1 1 0 7 6 COUNhOO5E -vEA~ - - NUMBER- - SOCIAL SECURITY NUMBER 458-90-8167 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 03. Remainder Return (date of death prior 10 12-13-82) o 5. Federal Estate Tax Return Required Q. 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) COMPLETE MAiliNG ADDRESS 1101 N. Front Sl. TELEPHONE NUMBER 717 234-3136 Harrisburg, PA 17102 X 0_(15) 78,111.27 x .o!:if (16) x .12 (17) X .15 (18) (19) z o j::: <( ..J ::J l- ii: <( (J w 0:: 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mort9ages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (totai Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule l) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) (1) (2) (3) (4) (5) (6) (7) (9) (10) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SiDE FOR APPliCABLE RATES z o j::: ~ ::J ll.. :E o (J >< <( I- 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due (8) (11) (12) (13) (14) 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT OFFICIAL USE ONL Y- -, I 97,225.481 ___J 97,225.48 18,989.21 125.00 19,114.21 78,111.27 78,111.27 1 :>/5", t:: I ~ 3 .5/5". 0 j . ~ - Decedents omDlete dress: . STREET ADDRESS 661 Mud level Road CITY I STATE PA I ZIP 17257 Shippensburg . C Ad Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 3,.-57:5'. OJ -e,ee- 967.50 50.92 Total Credits (A + 8 + C) (2) 1,018.42 3. InteresUPenalty if applicable D. Interest E. Penalty 7tf77- 7 "/7;2.. 5. TotallnteresUPenalty (0 + E) (3) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) 8. Enter the total of Line 5 + 5A. This is the 8ALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT 4. 1,~ 10..4]1- .2 /t'l b ,5'1 .e.oo. 71/.7;2. ~ 57t3/ 0.00 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN 'X' IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ........................................................................... 0 [Xl b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 IKI c. retain a reversionary interest; or ...................................................................................................... 0 ~ d. receive the promise for life of either payments, benefits or care? ............................................................. 0 [Xl 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration?.... .............................. ........................ .................... .......... ...... D [Z) 3. Did decedent own an "in trust fo~ or payable upon death bank account or security at his or her death? ................. 0 [Xl 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................... ....................... ..................... 0 IKI IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% 172 P.S. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use ofthe surviving spouse is 0% 172 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exemDt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% 172 P.S. ~9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) 172 P.S. ~9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use ofthe decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blooc or adoption. ..._,_____.___...'"'__N__.,...~.....,~_U_._-~_._...."-_. .I'~' DEPARTMENT 280601 HARRISBURG, PA 17128-0601 July 10, 2002 Telephone (717) 787-3930 FAX (717) 772-0412 Maxine Kay Lewis. Esq. 1101 North Front St. Harrisburg, Pa.17102 Dear Mr Lewis: Re: Estate of Samuel Spungin File Number21011076 ~f This is in response to your request for an extension of time to file the Inheritance Tax Return for the above estate. In accordance with Section 2136 (d) of the Inheritance and Estate Tax Act of 1995, the time for filing the return is extended for an additional period of six months. This extension will avoid the imposition of a penalty for failure to make a timely return. However, it does not prevent interest from accruing on any tax remaining unpaid after the delinquent date. The return must be filed with the Register of Wills on or before January 15,2003. Because Section 2136 (d) of the 1995 Act allows for only one extra period of six (6) months, no additional extension(s) will be granted that would exceed the maximum time permitted. Sincerely, . /) (, ... / " , '-/' / j/ . . Jeffrey D. Hollenbush, Supervisor Document Processing Unit Inheritance Tax Division . , ~ SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SPUNGIN SAMUEL Indude the proceeds oIlitigalion and the dale the proceeds were received by the _Ie. All property joiltly_ with the .vht 01 su_ip must be disclosed on Schedule F. FILE NUMBER 21 01 1076 ITEM NUMBER 1. DESCRIPTION Distribution from Estate of Fannie Spungin, Deceased VALUE AT DATE OF DEATH 97,225.48 Decedent lived in a group home - any possessions he may have had were given away. TOTAL (Also enteron line 5, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 97,225.48 - INRE: IN THE COURT OF COMMON PLEAS DAUPHIN COUNTY, PENNSYLVANIA ORPHAN'S COURT DMSION Estate of Fannie SplDlgin, Deceased No. 418 of 1961 ORDER AND NOW, this \~ day of \Y\.,o..,~ , 2002, after consideration of the Petition filed by Deborah Klabe, in her capacity as a beneficiary under the trust contained in the Last Will & Testament of Fannie Spungin, Deceased, and as Administratrix of the Estate of Samuel Spungin, Deceased, and no Answer having been filed to the Rule, the Account is hereby confirmed and per stirpes distribution decreed as follows: 1) 2) 3) 4) 5) 6) 7) 8) 9) - to Estate of Samuel Spungin, Deceased, 1/6 share of residuary: to Deborah Klabe, 1/6 share of residuary: to Charlotte S. Cohn, 1/9 share of residuary: to Sandra Lowe, 1/9 share of residuary: to Stephen SplDlgin, 1/9 share of residuary: to Lisa S. Mason, 1/12 share of residuary: to Janis Rndd, 1/12 share of residuary: to Nathan D. Spnngjn. .1/12 share of residuary: to Tena S. Wood, l/U share of residuary: $97,225.48 $97,225.29 $64,817.00 $64,816.99 $64,816.99 $48,612.75 $48,612.75 $48~612.75 $48,6l1'JlsEO MAR j; 20lJZ . .. .-,;;~1~~g. ACARFJZO_ , . Any additional distributions of income earned by the Testamentary trust since October 22,2001 shall be made to the above heirs on a per stirpes basis. This is a Nisi Order which shall become absolute as of course unless written exceptions are filed within ten (10) days of the filing hereof By the Court: 15 1 "I C"'1"d.~ ~~^ 9...."-.., J. Certified from the record as Absolute: Clerk of the Orphan's Court - CERTIFICATION COMMONWEALTH OF PENNSYL VANIA SS COUNTY OF DAUPHIN I, JANE D. MARFIZO, do hereby certifY that I am the duly elected Register ofWillslClerk of the Orphans' Court in and for the County of DAUPHIN Commonwealth of Pennsylvania, and as such duly elected official do hereby certifY that the attached ORDER Is a true and correct copy of the said document as it appears in the records of the Office of the Register ofWillslClerk of the Orphans' Court of said County. IN WITNESS WHEREOF, I have hereunto set my hand and official seal of my office this 14th day of MARCH , 2002, at HARRISBURG, Pennsylvania. ~"' .e. ?/t.tZAf'3'" egister ofWillslaerk of the OrphllDS' Court ~ ,. COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ~--.i____ ___ ____ ----..._-~~------ SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS I , I I ~~-~=--=__~ L_ _____ ___ FILE NUMBER - -------- ',-------- -------,--------- -~---,---,,-- ESTATE OF SPUNGIN. SAMUEL 21 01 1076 Debts of decedent must be reported on Schedule I. ---'ITEM -.------:---------------- -------- NUMBER A. DESCRIPTION ---==--_=~_~-:OU:;-- , i I , 4,230.50 1,600.00 1. 2. FUNERAL EXPENSES: Fogelsanger - Bricker Funeral Home (funeral, clergy and flowers Mount Moriah Cemetery B. 1. , ADMINISTRATIVE COSTS: Personal Representative's Commissioos NameofPelsonalRepresenlative(s) DEEl<:>'~H KLABE .. ___________ Social Security Numbe~s) I EIN Number of Personal RepresenlatNe(s) ...._.__ ..___._ StreetAddress ~~5 Cabinl::l()lIo\\l Rd=---_______ __. ._._.___ City [)iIIsbllr9 ____ SIBle "-A___ Zip 11()1.!l__ Yea~s) Commission Paid: 2<102 .______ A_eyFees MAXINE KAY LEWIS 33085 5,000.00 2. 3. B,OOO.OO Family Exemption: (It decedents address ~ not the same as claimants, allacl1 explanalion) Claimant Street Address City ___ Slale _____ Zip ____ .____._ Relationship of Claimanllo Deoedent 4. Probate Fees 45.00 5. Accountants Fees 6. Tax Return Preparef's Fees 7. 8. 9. US Postage Orphan's Court Fees Vital Records 57.71 50.00 6.00 --~---~-:----._-._-_.._- TOTAL (Also enter on line 9, Recapitulation) L $ _18,9Bfl:..21_ -'(lImor" spaceTsneOdecC ;I1sertadditionalsheelsofihe-same siie)- -- -.-- . ~ SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SPUNGIN SAMUEL FILE NUMBER 21 01 1076 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 125.00 1. Maxine Lewis - attorney fees, Power of Attorney TOTAL (Also enteron line 10, Recapitulalion) $ (If more space is needed, insert additional sheets of the same size) 125.0 - ~ COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESJDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER <O:PIINI:::I "'AlAl'CI 21 n1 1n71': RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Usl Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1. Dorothy M. Elder Mother 100% 495 Cabin Hollow Road DiIIsburg, PA 17019 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON UNES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON UNE 13 OF REV 1500 COVER SHEET $ .. (If more space IS needed, Insert additional sheets oIlhe same size) - . . ~ -""'~ '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER 21 01 1076 80unain Samuel Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION Further Distributions from the Estate of Lena Spungin, Deceased VALUE AT DATE OF DEATH 99,17700 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 99,177.00 REV-1500EX + (6-00) A - \1-,;;(0- ~ REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 I- Z W Cl W U W Cl DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) S un in, Samuel DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) 10/15/2001 09/06/1950 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) w .... ::r:::!U) ,,"'''' w~u :r"g ""-Ill "- < o 1. Original Return o 4. Limited Estate 06. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received [ZJ 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copy OfTrusQ o 10. Spousal Poverty Credit (date ofdealh between 12-31-91 and 1-1-95) OFFICIAL USE ONLY s: , FILE NUMBER 2 1 - 0 1 1 0 7 6 ""COUNTYCOOE -vEA~ - - Nrn:iB'ER-- SOCIAL SECURITY NUMBER 458-90-867 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder Return (date of death priIXIo 12-13-82) o 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach SchO) NAME MAXINE KAY LEWIS FIRM NAME (If Applicable) COMPLETE MAILING ADDRESS 1101 N. Front Street .... z w c z c "- '" w '" '" o " TELEPHONE NUMBER 717 234-3136 Harrisbur z o i= :s :> I- a: c:( u W II:: 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole.Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) (11) (12) (13) (8) 14. Net Value Subject to Tax (Line 12 minus line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) z o i= c:( I- :> Il. ::E o u >< c:( I- 15. Amount of line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_(15) 99,177.00 X .045 (16) X .12 (17) X .15 (18) (19) 16. Amount of line 14 taxable at lineal rate 17. Amount of Une 14 taxable at sibling rate 18. Amount of line 14 taxable at collateral rate 20. PA 17102 - OFFICIAL USE ONLY 99,177.00. 99,177.00 99,177.00 99,177.00 4,462.96 4,462.96 Decedent's ComDlete Address: STREET ADDRESS 661 Mud Level Road CiTY. b I STATE PA I ZIP 17257 Shlppens urg Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 4,462.96 Total Credits (A + B + C) (2) 3. InteresUPenalty if applicable D. interest E. Penalty Total interesUPenalty ( D + E ) (3) 4. II Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. if Line 1 + Line 3 is greater Ihan Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interesl on the tax due. (5A) B. Enter the lolal of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 4,462.96 4,462.96 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN 'X' IN THE APPROPRIATE BLOCKS 1. Did decedent make a Iransler and: Yes No a. retain the use or income offhe property transferred; ........................................................................... 0 ~ b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 ~ c. retain a reversionary interest; or ...................................................................................................... D IZl d. receive Ihe promise for life of either payments, benefits or care? ............................................................. 0 ~ 2. II dealh occurred after December 12, 1982, did decedent transfer property within one year 01 death without receiving adequate consideration?............................................. .,.. .................................. ........... 0 ~ 3. Did decedent own an 'in trustlor' or payable upon death bank account or security at his or her dealh? ................. 0 ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....... ........................................... ...... ,........ ........................... ........... 0 [g] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. " t 5 Cabin Hollow illsburg SIGNATURE OF r~EPARER OTHER THAN REPRESfJII< A TIVE /U~Ift'U2 c:" 1...UCv->-- ADDRESS 1101 N. Front Stree Harrisburg PA 17019 DATE 9/18/03 PA 17102 For dates of dealh on or after July 1, 1994 and belore January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 PS. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the lax rate imposed on the net value of transfers 10 or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the oniy beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoplive parent, or a stepparent of the child is 0% [72 P.S. ~9116(a)(I.2)]. The tax rate imposed on the net value 01 transfers to or for the use of the decedenl's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(I)J. The tax rate imposed on the net vaiue of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at leasl one parent in common with the decedent, whether by blood or adoption. JRD/June 30, 1992/17858 In Re: Estate of Samuel Spungin · ORPHANS' COURT DIVISION Late of Southampton Township · COURT OF COMMON PLEAS OF · CUMBERLAND COUNTY Estate No.: 21-01-1076 · PENNSYLVANIA NO. 21~01-1076 NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: Deborah Klabe Counsel for Personal Representative: Maxine Kay Lewis Date of Decedent's Death: 10/15/2001 Date of Delinquency Notice: 08/11/04 The undersigned, Glenda Famer-Strasbaugh, Clerk of Orphans' Court, in accordance with Rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Clerk of the Orphans' Court on April 30, 2004, and that the ten (10) day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 11/08/04 ~..._/.* ~.'__, ~ er StrasDaugn /// Clerk of the Orphans' Court Distribution: Personal Representative Counsel for Personal Representative Estate File A hearing is scheduled for at in Courtroom No. 3. If the Status Report is filed prior to the hearing date, the hearing will automatically be cancelled. Date°fDeath:-![)/]~/O] ?~J~?,'l~ WillNo.: ~--~/-"0J--/0~ Admin. No.. 2~' Pursuit to Rule 6.12 of~e Supreme Cou~ OCh~s' Com~ Rules, I repo~ the following wi~ respect to completion of the adm~s~ation of the above-captioned estate: 1. State whether a~stration of~e estate is complete: Yes~ No~ 2. If~e ~swer is No, state when the personal representative reasonably believes · at ~e a~i~s~ation will be complete: 3. ~the answer to No. 1 is Yes, state the follow,g: a. Did the personal ~resentative file a ~al accost with the Co~9 Yes _ No ' b. The sep~ate OCh~' Co~ No. (iffy) for ~e personal representative's accost is: c. Did the persona/representative state an account informally to the part/es in interest? Yes ~ No [-] c. Copies of receipts, releases, joinders and approval o£formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this repqrt. Name · -- Address ':;' -- Tvlephone No. Capacity: [] Personal Rer>resentative ~] Counsel for~personal representative.